Scaphoid pseudarthrosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

History of trauma to the left wrist 6 years ago with persistent pain.

Patient Data

Age: 35 years
Gender: Male
mri
This study is a stack
Coronal
T1
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Coronal T2
fat sat
This study is a stack
Coronal
T2
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Coronal T1
fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
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Info

Old scaphoid fracture with non-union of the bony fragments and presence of minimal fluid within the fracture line. No evidence of osteonecrosis of the bony fragments. Narrowing of the radioscaphoid joint space with marginal osteophyte of the radial styloid and thickening with the enhancement of the radial collateral ligament.

There is also mild degenerative changes of the proximal aspect of the lunate bone and in the capitate. On the sagittal sequence, the lunate bone is dorsally tilted with moderately increased lunocapitate angle at 35° (normal <30°) indicating probably a dorsal intercalated segment instability.

Case Discussion

MRI features of a scaphoid pseudarthrosis with secondary carpal instability (dorsal intercalated segment instability).

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